Clinical types and features of chronicity of drug-induced liver injury / 临床肝胆病杂志

ABSTRACT

ObjectiveTo investigate the clinical types and features of chronicity of drug-induced liver injury (DILI). MethodsThe patients who were diagnosed with DILI in Beijing You′An Hospital, Capital Medical University from January 2011 to December 2013 were screened, and a retrospective analysis was performed for 84 patients with chronic DILI. The case report form was filled out for each patient, and the data were entered into a database, including demographic features, underlying diseases, types of drugs, cardinal symptoms and signs, and laboratory examinations. ResultsOf all patients, 63 (75.0%) were female. The chronicity of DILI could be divided into six clinical types according to disease progression and recovery of liver function; of all patients, 64 (762%) had a recurrent type, 4 (4.8%) had a delayed recovery type, 4 (4.8%) had a recurrent fluctuation type, 6 (7.1%) had a chronic cholestasis type, 5 (6.0%) had a type of rapid progression to liver cirrhosis, and 1 (1.2%) had a type of drug-induced autoimmune hepatitis. Among all the 84 patients, 56 (66.7%) had underlying diseases; 51 (60.7%) had DILI induced by a single drug, mainly traditional Chinese medicine (47.0%), antipyretics and analgesics (10.6%), and antitubercular agents (9.1%); as for the type of liver injury, 52 (61.9%) had hepatocyte injury, 8 (9.5%) had cholestasis, and 5 (6.0%) had a mixed type. Liver biochemistries showed abnormal results in 19 patients (22.6%). ConclusionThe chronicity of DILI can be divided into six clinical types, of which the most common type is the recurrent type, and the other clinical types include delayed recovery type, recurrent fluctuation type, chronic cholestasis type, rapid progression to liver cirrhosis, and drug-induced autoimmune hepatitis.